Healthcare Affordability

Healthcare costs are a real and growing burden for American families, and hospitals share that concern. Understanding who is driving those costs matters for finding real solutions.

66%

of adults worried about affording healthcare for themselves and their family

KFF Health Tracking Poll, Jan. 2026

51%

worry about paying for needed healthcare services — up from 42% in 2021

West Health-Gallup, 2025

26.7M

Americans under 65 without health coverage in 2024 — up 1.3 million from 2023

KFF/U.S. Census ACS, 2024

<50%

of Americans can consistently afford the care they need — a five-year low

West Health-Gallup Affordability Index, 2025

Hospitals carry the weight of a complex system

Hospitals do not control most of the major cost drivers in healthcare, but they absorb the financial consequences of them. Rising labor costs, pharmaceutical prices, supply chain disruptions, and increasing red tape from insurers all add pressure to the cost of providing care.

Additionally, hospitals aren’t always fully paid for the care they provide to patients. This unpaid care comes from underpayment from government insurers like Medicare and Medicaid and caring for patients who can’t pay because they don’t have insurance coverage or have coverage with high out-of-pocket expenses.

Unfortunately, more Tennesseans are finding themselves without health insurance, or with limited coverage with lower monthly costs but higher out-of-pocket costs when they need care. At the same time, enrollment in Marketplace health plans is expected to decline as the federal premium assistance program expired, making coverage less affordable for many families.

NATIONAL – SINCE 2000

$745B

in uncompensated care

Since 2000, U.S. hospitals have provided nearly $745 billion in uncompensated care — delivering treatment regardless of a patient’s ability to pay.

Source: American Hospital Association – aha.org/fact-sheets/2020-01-06-fact-sheet-uncompensated-hospital-care-cost

TENNESSEE – ANNUAL

$5B+

in unpaid care each year

Each year, Tennessee hospitals shoulder more than $5 billion in unpaid care for uninsured and underinsured patients — absorbed by the institutions serving every community in the state.

Source: Tennessee Hospital Association

Insurance Red Tape Burdens Patients and Providers and Increases Healthcare Costs

Behind every healthcare bill is a web of insurer rules designed to slow down or limit care like prior authorization, claim denials, step therapy, referral requirements, or other restrictions. Each one adds delay, cost, and frustration for patients and the providers trying to treat them. 

Some tactics insurers use to slow down or limit care:

Prior Authorization

Insurers require advance approval before a patient can receive certain treatments, even when a doctor has already determined the care is necessary.

93% of physicians report delays

Claim Denials

Insurers reject claims for care already provided, often over paperwork technicalities, forcing hospitals to spend time and money appealing decisions for care patients already received.

11.8% of claims initially denied

Step Therapy & Fail-First Policies

Patients are required to try, and fail on, cheaper treatments before insurers will approve the medication or therapy their doctor originally recommended.

Often delays the most appropriate care

Referral Restrictions

Narrow networks and referral hoops add extra steps and delays before patients can see the specialist their doctor refers them to.

Adds steps between diagnosis and treatment

Formulary Exclusions

Insurers remove medications from covered drug lists, including common generics like insulin and albuterol, forcing patients to switch treatments or pay out of pocket.

Denials for essential meds up 16% since 2018

Documentation & Coding Hurdles

Claims are denied over technicalities like a missing form, an outdated code, or an incomplete field, requiring rework that delays payment for care already delivered.

$57 average cost to rework one denied claim

The Toll on Patients and Providers

93%

of physicians report prior authorization delays patient care

American Medical Association

80%

say these delays cause patients to abandon treatment altogether

American Medical Association

43%

of U.S. physicians report symptoms of burnout

Commonwealth Fund, 2025

65%

cite insurance-related admin tasks as a major driver of that burnout

Commonwealth Fund

What Happens When Insurance Red Tape Stands in the Way

THA0962_Icons_Numbers_1

Care is Requested
Physician orders treatment

THA0962_Icons_Numbers_2_BLUE

Insurer Review Delays It
93% of physicians see delays

THA0962_Icons_Numbers_3_BLUE

Patients Give Up, or Claims are Denied
80% report treatment abandonment

THA0962_Icons_Numbers_4

Costs Rise System-Wide
$35B in added annual cost

The cost doesn’t disappear. Every denied claim, every prior authorization delay, every step therapy requirement adds administrative work that hospitals and physicians must absorb, driving up the cost of delivering care.

$35B

added to the healthcare system every year by prior authorization alone, on top of the cost of denials, appeals, and rework across the system

Despite these pressures, Tennessee hospitals continue to care for their communities and treat every patient who walks through the door, regardless of their ability to pay.

THA0962_Icon_HOSPITAL

Open 24/7
Emergency & Safety Net Care
$1.4 Billion in Charity Care

THA0962_Icon_PATIENT

872,575 Admissions
Over 3.4 Million ED Visits

THA0962_Icon_FAMILY

85,000 Births Annually

Hospitals Care About Healthcare Affordability

Hospitals know healthcare costs are a real burden for Tennessee families. From price transparency to care models built to keep people healthier and out of the hospital, hospitals are actively working to lower costs and give patients clear, upfront information about what care will cost.

Posting Prices Upfront

Hospitals publish standard charges and out-of-pocket cost estimates so patients know what to expect before they receive care.

Coordinating Care to Prevent Costly Hospitalizations

Care coordination and chronic disease management programs help keep patients healthy and out of the emergency room in the first place.

Investing in Technology that Lowers Costs

Telehealth, remote monitoring, and other technology investments reduce unnecessary ER visits and readmissions for patients and families.

Finding Efficiencies without Cutting Care

Hospitals continuously work to reduce operating expenses through smarter operations — protecting the quality of care patients receive.

Sources: American Medical Association, Prior Authorization Survey 2025 (ama-assn.org); Commonwealth Fund, Causes and Impacts of Burnout Among Primary Care Physicians, Nov. 2025; Health Affairs, Current Prior Authorization Landscape (healthaffairs.org); American Hospital Association, Skyrocketing Hospital Administrative Costs report, 2024 (aha.org); HHS Office of Inspector General, Medicare Advantage denials report; Aptarro, US Healthcare Denial Rates & Reimbursement Statistics 2026; AJMC, How Insurance Claim Denials Harm Patients’ Health and Finances.